Get Uhg Pathology Request Form - Thyroid Function Test - August 2009docx

This guide will assist you in completing the UHG Pathology Request Form for Thyroid Function Test online. Follow these clear instructions to ensure all necessary information is accurately filled out.

Follow the steps to successfully complete the form:

1. Press the ‘Get Form’ button to obtain the form and open it in the editor for online completion.
2. Enter your applicant details, including your UHG / HSN ID number, given name, surname, address, state, postcode, date of birth, and gender.
3. Fill in the section for pathology data entry, specifying the duplicate copy results to be sent to a doctor, including their fax number and details.
4. Indicate the tests requested by marking an ‘X’ next to each applicable test. Make sure to clearly mark 'Thyroid Function Test' among the listed tests.
5. If required, provide the fasting status by indicating whether you have fasted and specify the number of fasting hours.
6. The collector should sign and include their name, collection time, and any identification type provided by the applicant in the identification section.
7. The applicant must read and sign the privacy statement and their declaration, ensuring they understand the consent for testing and release of results.
8. Once all fields are completed, you can save changes, download the completed form, or print it for filing.

Complete your documents online to ensure efficiency and accuracy in your submissions.